Soft drink industry's focus should be on child nutrition in developing world

Soft drink companies are well-positioned to help combat child malnutrition in developing countries because of their expanding business and extensive distribution routes. UCSF experts are advocating for these companies to implement public health programs that exploit their access to remote markets by producing healthier products, such as bottled water fortified with essential nutrients.

Janet Wojcicki, PhD, MPH, UCSF assistant professor of pediatrics, and Melvin Heyman, MD, MPH, chief of pediatric gastroenterology, hepatology and nutrition at UCSF Benioff Children’s Hospital, explore how the beverage industry can potentially improve child health in Sub-Saharan African countries and other developing nations in a new article in the journal Pediatrics.

Increasingly, soft drink companies supply products with little or no nutritional value to the developing world, where high rates of malnutrition are a stark contrast to the ongoing obesity epidemic in developed countries. Nearly 80 million servings of Coca-Cola products are consumed in Sub-Saharan Africa each day; Coca-Cola plans to double its investments in African markets in 2010 and estimates its retail sales will expand by more than $600 billion by 2020.

Meanwhile, many children in these countries continue to have stunted growth and serious nutrient deficiencies. According to the World Health Organization, more than 67 percent of African preschool-aged children suffer from iron deficiency anemia, and 44 percent have a vitamin A deficiency.

“We are living in a world that simultaneously has problems of obesity and malnutrition. However, efforts targeted at beverage companies tend to focus solely on developed markets and the problem of obesity, without recognizing the increasingly large role these companies play in feeding people in the developing world,” Wojcicki said. “Public health initiatives should push the beverage companies to similarly provide healthier products to people in the developing world.”

Wojcicki and Heyman propose that soft drink companies work with public health interests to begin manufacturing products fortified with the vitamins and minerals often lacking in the food supply in developing countries. Furthermore, by using the companies’ widespread manual distribution centers, which rely on bicycles, pushcarts and other similar transportation to access hard-to-reach sellers, healthier products can be delivered to remote locations and have a greater impact.

“We are not trying to encourage the use of soft drinks, but as these companies produce a broad array of products and their products are being used more and more, they should provide beverages that include additives to help improve some of the serious nutrition issues in the developing world,” Heyman said.

The authors contend that bottled water is the ideal vehicle for nutrient fortification, especially since the sale of bottled water is expected to grow rapidly in African markets due to the poor quality of potable water in many areas.

“Public health officials should put pressure on beverage companies to provide a product that both does not contribute to the obesity epidemic and has the potential to provide nutritional benefit. Fortifying bottled waters would also have the added benefit of providing access to safe, clean water in areas that may not have easy availability,” they conclude.